International Braz J Urol最新文献

{"title":"The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome.","authors":"Shuai Yang, Zhaokai Zhou, Xingchen Liu, Zhan Wang, Yanping Zhang, He Zhang, Lei Lv, Yibo Wen, Qingwei Wang, Wei Jia, Jinhua Hu, Jian Guo Wen","doi":"10.1590/S1677-5538.IBJU.2024.0311","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0311","url":null,"abstract":"<p><strong>Purpose: </strong>Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary Tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS.</p><p><strong>Materials and methods: </strong>A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters.</p><p><strong>Results: </strong>A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively.</p><p><strong>Conclusions: </strong>DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking Among Pioneers - Sperm DNA Fragmentation and a Growing Focus on Male Factor Infertility.","authors":"Robert Matthew Coward","doi":"10.1590/S1677-5538.IBJU.2024.9925","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9925","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Technological and Intraoperative Performances of Da Vinci xi and DaVinci 5 Robotic Platforms in Patients Undergoing Robotic-Assisted Radical Prostatectomy.","authors":"Ahmed Gamal, Marcio Covas Moschovas, Shady Saikali, Sumeet Reddy, Yu Ozawa, Rohan Sharma, Avaneesh Kunta, Travis Rogers, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2024.0569","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0569","url":null,"abstract":"<p><strong>Introduction: </strong>In the last two decades, several Da Vinci robotic platforms have been released in the market, revolutionizing the field of robotic-assisted surgery (1, 2).The system has seen numerous modifications, with several Da Vinci® robotic models being introduced, each featuring ongoing technological advancements in ergonomics,instrumentation,high-definition imaging, EndoWrist™ technology, and single-port surgery capabilities (3, 4).Building on this, the new generation Da Vinci 5 robot promises significant hardware and software improvements, with the potential for enhanced operative performance (2, 5). In this video, we will illustrate several technical advancements of the Da Vinci 5.</p><p><strong>Material and methods: </strong>We performed a video compilation comparing the Da Vinci 5 and Da Vinci Xi during radical prostatectomy. The video will highlight the technical modifications of the new platform, showcasing the advancements and improvements in the Da Vinci 5 system. Additionally, this video will illustrate key aspects of the surgery, including anterior bladder neck access, lateral bladder dissection from the prostate, posterior prostate dissection and anastomosis.</p><p><strong>Surgical technique: </strong>We performed our RARP technique with our standard approach in all patients (6-8). With this new platform, we maintained our conventional technique without any modifications or adaptions from the trocar placement until anastomosis. The beginning of the case is performed as usual, we first identify the anterior bladder neck and then complete its dissection with Maryland and Scissors. Then, we proceed to the posterior bladder neck dissection, seminal vesicles control and nerve-sparing. In sequence, we control the prostate arterial pedicles with hem-o-lok clips and then we perform the apical dissection until dividing the urethra. Finally, we perform the hemostasis, posterior reconstruction (Rocco's technique) and anastomosis with barbed suture.</p><p><strong>Results: </strong>The Da Vinci 5 features several key upgrades. The first part of our video described the console, patient cart, and energy tower modifications. The console has been ergonomically redesigned for a flat neck posture to decrease muscle fatigue, and the handgrip now includes a rubber surface for better grip (9). The patient cart, similar to the previous generation, has updated helm interfaces and integrated commands with the console and vision tower. In sequence, we described the instrument modifications and the step-by-step technique showing the DV5 and DV-Xi. Force feedback instruments provide three degrees of tactile feedback, enhancing tissue manipulation. A new security system ensures instruments can only be inserted when clear of tissues and obstructions, reducing the risk of errors. Another modification regards the ability to switch instruments and camera.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Double Helix to Double Trouble: Sperm DNA Fragmentation Unveiled - A Reproductive Urologist Perspective (AUA Bruce Stewart Memorial Lecture - ASRM 2024).","authors":"Sandro C Esteves","doi":"10.1590/S1677-5538.IBJU.2024.9924","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9924","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Telesurgery Connectivity Between North and South America: the first Remote Surgery Conducted Between Orlando and São Paulo in Animal Models.","authors":"Marcio Covas Moschovas, Shady Saikali, Mischa Dohler, Ela Patel, Travis Rogers, Ahmed Gamal, Jeffrey Marquinez, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2024.0601","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0601","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers are fundamental to success of the International Brazilian Journal of Urology.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.01.02","DOIUrl":"10.1590/S1677-5538.IBJU.2025.01.02","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Management of Children and Adolescents with Overactive Bladder Refractory to Treatment with Parasacral Transcutaneous Electrical Nerve Stimulation.","authors":"Carlos Eduardo Rocha Macedo, Antônio Vitor Nascimento Martinelli Braga, Felipe Santos Marimpietri, Beatriz Paixão Argollo, Glicia Estevam de Abreu, Maria Luiza Veiga da Fonseca, Ana Aparecida Nascimento Martinelli Braga, Ubirajara Barroso","doi":"10.1590/S1677-5538.IBJU.2024.0453","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0453","url":null,"abstract":"<p><strong>Background: </strong>Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not respond to pTENS.</p><p><strong>Material and methods: </strong>This retrospective case series examined patients aged 4-17 years. Patients were given subsequent treatment options, including: behavioral therapies; oxybutynin; imipramine; a combination of oxybutynin and imipramine; parasacral percutaneous electrical nerve stimulation (PENS); or a repeat course of pTENS. Outcomes were evaluated using the Dysfunctional Voiding Scoring System (DVSS) and the Visual Analogue Scale (VAS).</p><p><strong>Results: </strong>Thirty children were included, with a median age of 7 years. Patients received one or more treatments. Of these, 70% underwent monotherapy. Among them, 57% experienced complete resolution of symptoms, 28% had partial resolution and were satisfied with the results, and 14% discontinued treatment. 30% out of the whole sample continued to experience bothersome symptoms. Complete response, according to initial subsequent, was achieved in: 54% with intensified behavioral therapies, 33% with oxybutynin, and 50% with imipramine alone. The median DVSS score decreased from 7.0 to 2.0 (p=0.025), while the median VAS score increased from 80 to 100 (p<0.001).</p><p><strong>Conclusion: </strong>Children with OAB refractory to pTENS who received structured subsequent treatments showed partial response in all cases, with complete symptom resolution in half of the patients. More intensive urotherapy, medications, or repeat pTENS in combination with oxybutinin can be effective for managing this challenging condition.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: Targeting Heme in Sickle Cell disease: New Perspectives on Priapism Treatment.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2024.9926","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9926","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Climacturia in Patients after Radical Prostatectomy: A Systematic Review.","authors":"João Vítor Ferrão, Alice Scalzilli Becker, Gustavo Bangemann Bangemann, Thiago Minossi Oliboni, Nilson Marquardt, Carlos Teodósio da Ros, Gustavo Franco Carvalhal, Gustavo Konopka","doi":"10.1590/S1677-5538.IBJU.2024.0406","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0406","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate Cancer (PCa) is the most common non-cutaneous cancer in males, and Radical Prostatectomy (RP) is among the primary treatments for this condition. Our study aims to investigate the prevalence of climacturia (urine leakage at the moment of the climax), a potential post-RP change related to orgasm.</p><p><strong>Material and methods: </strong>A systematic review was conducted following PRISMA guidelines and registered on the PROSPERO platform. The search was performed using MEDLINE via PubMed.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria and were described separately. Within these studies, 5,208 patients were evaluated, among which 1,417 cases of climacturia were identified, with a prevalence of 27.2%. When we analyzed the robot-assisted radical prostatectomy (RARP) subgroup, the prevalence of climacturia was 5.7% vs 1.8% the open radical prostatectomy (ORP) subgroup.</p><p><strong>Conclusion: </strong>Climacturia is a frequently underestimated complication by urologists. Given its significant impact on quality of life, it warrants greater attention from specialists following RP.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Gleason 7 (3+4) and (4+3) Prostatic Adenocarcinomas with Prognostic Criteria and Immunohistochemical Profiles of AMACR, PSA and Ki-67.","authors":"Clarice F E M Osório, Waldemar S Costa, Carla B M Gallo, Luciano A Favorito, Francisco J B Sampaio","doi":"10.1590/S1677-5538.IBJU.2024.9922","DOIUrl":"10.1590/S1677-5538.IBJU.2024.9922","url":null,"abstract":"<p><strong>Background: </strong>To compare Gleason 7 (3+4) and (4+3) prostatic adenocarcinoma (PC) with different prognostic criteria through immunohistochemical analysis with anti-PSA, anti-Ki 67 and anti-AMARC antibodies.</p><p><strong>Methods: </strong>We analyzed 221 surgical specimens from patients between 40 and 86 years-old (mean=63) with PC. The immunohistochemical study was performed with anti-PSA, anti-Ki 67 and anti-AMARC. The microscopic fields were photographed with an Olympus DP70 digital camera coupled to an Olympus BX51 microscope and archived in TIFF. Proportion and intensity criteria were used to quantify the anti-PSA antibody and for the anti-Ki 67 antibody, the quantification by similarity of this antibody in breast carcinomas. Anti-AMACR protein expression was based on four scores: negative, weak, moderate and strong. The statistical analysis was performed with the Graph Pad Prism 5 program.</p><p><strong>Results: </strong>In the Gleason score 7 (3+4) we had 91.72% in pT2 and 8.27% in the pT3 group; 8.27% recurrences, of which 90.90% in the pT2 group. In the Gleason score 7 (4+3) we had 77.27% in the pT2 group and 22.72% in the pT3 group and 10.22% of relapses, of which 66.66% in the pT2 group and 33.33% in the pT3 group. In 6.81% of cases there was an increase in the anti-Ki 67 index and in 2.27% of the cases, there was an increase in the immunoexpression of anti-p53 when comparing Gleason score 7 (3+4) with Gleason score 7 (4+3).</p><p><strong>Conclusion: </strong>Our study confirmed differences in the Gleason score 7 (3+4) and Gleason score 7 (4+3) of PC when comparing prognostic criteria. Anti-Ki 67 and anti-PSA antibody immunostaining showed a positive correlation as the Gleason score 7 increased from (3+4) to (4+3).</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"50 ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}